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Obesity

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Sedentary lifestyle levels are on the rise; global estimates show that one in four adults and 81% of adolescents do not engage in enough physical activity (PA). The changes in transportation patterns, increased use of technology, cultural values and urbanization have influenced this behavior [1]. Furthermore, sedentary behavior represents the lower level of the spectrum of PA; the construct is defined as those activities that represent a low energy expenditure.
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The prevalence of obesity is increasing world-wide. Obesity is associated with a plethora of metabolic and clinical constraints, which result in a higher risk for the development of cardiovascular complications and metabolic disease, particularly insulin resistance and type 2 diabetes. Obesity is an acknowledged determinant of glycemic control in patients with type 1 diabetes and accounts for the majority of premature death due to cardiovascular events. Physical exercise is generally recommended in patients with diabetes in order to prevent the development of or reduce existing obesity, as adopted by every international treatment guideline so far.
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Physical activity is recognized as a basic component of the management of the obese child, but it is not clear which kind of intervention is the most efficient. The aim of this study is to evaluate the effect of prescribed exercise training in obese children. We reviewed 19 studies, 10 RCT and 9 observational studies, published in the last 5 years. In the majority of these studies obese children were treated as ambulatory patient, in tertiary centers. Only 2 studies described a community based program. In half of the studies, drop-out was not reported and the rate of attendance was rarely described. On the other hand, the content of each session was well described, but exercise training intensity was below international recommendations.
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